- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.41 / $8.91 / $104.71
| Facility | | $1.41 | $8.91 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $1.07 / $2.95
| Professional | | $1.07 | $1.07 | $2.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.14 / $0.33 / $0.63
| Facility | | $0.14 | $0.33 | $0.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.05 / $0.05 / $0.08
| Professional | | $0.05 | $0.05 | $0.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.56 / $1.00 / $22.39
| Facility | | $0.56 | $1.00 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $6.61 / $6.61
| Facility | | $6.61 | $6.61 | $6.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.26 / $0.58 / $1.55
| Facility | | $0.26 | $0.58 | $1.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.23 / $0.23 / $0.23
| Professional | | $0.23 | $0.23 | $0.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.95 / $8.91 / $128.82
| Facility | | $0.95 | $8.91 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.20 / $1.07 / $2.95
| Professional | | $0.20 | $1.07 | $2.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $30.20 / $30.20
| Professional | | $30.20 | $30.20 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.23 / $0.46 / $1.00
| Facility | | $0.23 | $0.46 | $1.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.23 / $0.23 / $0.23
| Professional | | $0.23 | $0.23 | $0.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.68 / $0.91 / $0.91
| Facility | | $0.68 | $0.91 | $0.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.22 / $0.22 / $0.22
| Professional | | $0.22 | $0.22 | $0.22 |